Mathew Alphonsa, Varghese Salish, Chathappan Rajeev Punchalil, Palatty Babu Urumese, Chanchal A B Vijay, Abraham Siju V
Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
J Emerg Trauma Shock. 2024 Jul-Sep;17(3):166-171. doi: 10.4103/jets.jets_139_23. Epub 2024 Aug 2.
Prehospital capabilities are inadequately developed to meet the growing needs for emergency care in most low- and middle-income countries. This study aims to describe the prehospital care received by the road traffic injury (RTI) victims presenting to a level I Trauma Care Center in Central Kerala, India.
This was a hospital-based prospective observational study, which included consecutive victims of RTI attending the emergency department within 24-h of the event. A structured interview schedule was developed for collecting the data on various domains and the patients were followed up for their duration of hospital stay.
A total of 920 RTI victims, were included in this study. Two percent (17/920) of first responders had some sort of training in trauma care whereas the rest were untrained. The time taken to get any help at the scene after an RTI was 8 ± 12.9 min (95% confidence interval [CI] 7.16-8.84) and for first medical contact 25 ± 16 min (95% CI 24-26). No attempt at field stabilization occurred in any case. Three percent (26/920) had received some form of prehospital care, like arrest of hemorrhage using a compression bandage and splinting of the fractured limb with a wooden plank. None of the patients received supplemental oxygen, airway management, or cervical spine immobilization at the site of the accident or en route to the hospital.
A lack of an organized prehospital care system results in minimal care before hospital admission. Urgent establishment of ambulance services and structured prehospital care tailored to our health-care system is imperative.
在大多数低收入和中等收入国家，院前急救能力的发展不足以满足日益增长的紧急护理需求。本研究旨在描述印度喀拉拉邦中部一家一级创伤护理中心收治的道路交通伤（RTI）受害者所接受的院前护理情况。
这是一项基于医院的前瞻性观察性研究，纳入了在事件发生后24小时内到急诊科就诊的连续的RTI受害者。制定了一份结构化访谈提纲，用于收集各个领域的数据，并对患者的住院时间进行随访。
本研究共纳入920名RTI受害者。2%（17/920）的第一反应者接受过某种创伤护理培训，其余均未接受过培训。RTI发生后在现场获得任何帮助的时间为8±12.9分钟（95%置信区间[CI]7.16 - 8.84），首次医疗接触时间为25±16分钟（95%CI 24 - 26）。在任何情况下均未尝试进行现场稳定处理。3%（26/920）的患者接受过某种形式的院前护理，如使用压迫绷带止血和用木板固定骨折肢体。在事故现场或送往医院途中，没有患者接受补充氧气、气道管理或颈椎固定。
缺乏有组织的院前护理系统导致入院前护理极少。迫切需要建立救护车服务，并根据我们的医疗保健系统制定结构化的院前护理。
